Provider Demographics
NPI:1841313111
Name:HATCH, LANA
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:HATCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30325 538 AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MN
Mailing Address - Zip Code:55950
Mailing Address - Country:US
Mailing Address - Phone:507-437-9185
Mailing Address - Fax:507-437-9198
Practice Address - Street 1:1001 18TH AVE NW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-1890
Practice Address - Country:US
Practice Address - Phone:507-437-9185
Practice Address - Fax:507-437-9198
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist